Health Data Analyst / Revenue Integrity Analyst - Revenue Cycle Hrr-24-03919

Title-Health Data Analyst / Revenue Integrity Analyst - Revenue Cycle 

Pay Rate: $45.00-$50.00/Hour

Job Description

The Health Data Analyst / Revenue Integrity Analyst plays a key role in optimizing Revenue Cycle performance and ensuring accurate reimbursement for healthcare services. This position involves analyzing healthcare data, identifying Revenue Cycle trends and opportunities, and implementing strategies to improve revenue capture, coding accuracy, and compliance with regulatory requirements.

Key Responsibilities:

• Analyze healthcare data, including billing records, claims data, coding data, and reimbursement trends, to identify patterns, anomalies, and opportunities for revenue enhancement.
• Conduct comprehensive reviews of coding practices, charge capture processes, and billing documentation to ensure accuracy, completeness, and compliance with coding guidelines, payer regulations, and industry standards.
• Collaborate with coding specialists, clinical documentation improvement (CDI) specialists, and Revenue Cycle stakeholders to address coding discrepancies, documentation deficiencies, and coding-related denials.
• Perform audits and reviews of billing and coding processes, including evaluation of coding accuracy, coding compliance, and Revenue Integrity risks, and recommend corrective actions as needed.
• Develop and implement data-driven strategies and initiatives to optimize Revenue Cycle performance, minimize revenue leakage, and improve reimbursement accuracy and timeliness.
• Monitor and analyze reimbursement trends, payer denials, and accounts receivable metrics to identify root causes of Revenue Cycle inefficiencies and develop targeted interventions to address revenue leakage and improve financial performance.
• Collaborate with Revenue Cycle teams, finance departments, and clinical departments to facilitate Revenue Cycle improvement initiatives, including process redesign, workflow optimization, and system enhancements.
• Provide education and training to Revenue Cycle staff, coding professionals, and clinical providers on coding guidelines, documentation requirements, and Revenue Cycle best practices to promote coding accuracy and compliance.
• Stay abreast of regulatory changes, coding updates, reimbursement policies, and industry trends impacting Revenue Cycle operations, and ensure organizational compliance with relevant regulations and guidelines.
• Prepare and present reports, dashboards, and analysis findings to key stakeholders, including Revenue Cycle leadership, executive management, and regulatory agencies, to support decision-making and strategic planning efforts.

Qualifications:

• Bachelor's degree in Health Information Management, Healthcare Administration, Finance, or related field required; Master's degree preferred.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Revenue Cycle Professional (CRCP) certification preferred.
• Minimum of 3-5 years of experience in healthcare Revenue Cycle management, Revenue Integrity, coding compliance, or healthcare data analysis roles.
• Proficiency in healthcare data analysis tools and software, including Microsoft Excel, SQL, Tableau, or other data visualization and analytics platforms.
• In-depth knowledge of healthcare Revenue Cycle processes, billing operations, coding principles, and reimbursement methodologies across multiple payer types (e.g., Medicare, Medicaid, commercial payers).
• Strong analytical and problem-solving skills, with the ability to interpret complex data sets, identify trends and patterns, and make data-driven recommendations to improve Revenue Cycle performance.
• Excellent communication and interpersonal skills, with the ability to collaborate effectively with multidisciplinary teams, communicate complex concepts to diverse audiences, and influence stakeholders at all levels of the organization.
• Detail-oriented with a focus on accuracy, quality, and compliance in coding and billing practices.
• Ability to prioritize tasks, manage multiple projects concurrently, and meet deadlines in a fast-paced healthcare environment.
• Commitment to continuous learning and professional development, including staying current with industry regulations, coding guidelines, and best practices in Revenue Cycle management.